Pre-morbid sleep disturbance and its association with stroke severity: results from the international INTERSTROKE study

Christine E Mc Carthy*, Salim Yusuf, Conor Judge, John Ferguson, Graeme J Hankey, Shahram Oveis Gharan, Albertino Damasceno, Helle Klingenberg Iversen, Annika Rosengren, Okechukwu Ogah, Luísa Avezum, Patricio Lopez-Jaramillo, Denis Xavier, Xingyu Wang, Sumathy Rangarajan, Martin J O'Donnell

*Corresponding author af dette arbejde
1 Citationer (Scopus)

Abstract

BACKGROUND AND PURPOSE: Whilst sleep disturbances are associated with stroke, their association with stroke severity is less certain. In the INTERSTROKE study, the association of pre-morbid sleep disturbance with stroke severity and functional outcome following stroke was evaluated.

METHODS: INTERSTROKE is an international case-control study of first acute stroke. This analysis included cases who completed a standardized questionnaire concerning nine symptoms of sleep disturbance (sleep onset latency, duration, quality, nocturnal awakening, napping duration, whether a nap was planned, snoring, snorting and breathing cessation) in the month prior to stroke (n = 2361). Two indices were derived representing sleep disturbance (range 0-9) and obstructive sleep apnoea (range 0-3) symptoms. Logistic regression was used to estimate the magnitude of association between symptoms and stroke severity defined by the modified Rankin Score.

RESULTS: The mean age of participants was 62.9 years, and 42% were female. On multivariable analysis, there was a graded association between increasing number of sleep disturbance symptoms and initially severe stroke (2-3, odds ratio [OR] 1.44, 95% confidence interval [CI] 1.07-1.94; 4-5, OR 1.66, 95% CI 1.23-2.25; >5, OR 2.58, 95% CI 1.83-3.66). Having >5 sleep disturbance symptoms was associated with significantly increased odds of functional deterioration at 1 month (OR 1.54, 95% CI 1.01-2.34). A higher obstructive sleep apnoea score was also associated with significantly increased odds of initially severe stroke (2-3, OR 1.48; 95% CI 1.20-1.83) but not functional deterioration at 1 month (OR 1.19, 95% CI 0.93-1.52).

CONCLUSIONS: Sleep disturbance symptoms were common and associated with an increased odds of severe stroke and functional deterioration. Interventions to modify sleep disturbance may help prevent disabling stroke/improve functional outcomes and should be the subject of future research.

OriginalsprogEngelsk
Artikelnummere16193
TidsskriftEuropean Journal of Neurology
Vol/bind31
Udgave nummer6
Sider (fra-til)e16193
ISSN1351-5101
DOI
StatusUdgivet - 2024

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